Impact of PSA flare-up in patients with hormone-refractory prostate cancer undergoing chemotherapy

Nelius, Thomas; Klatte, Tobias; Riese, Werner de; Filleur, Stéphanie

doi:10.1007/s11255-007-9221-y

Cited by 36 publications

(37 citation statements)

References 32 publications

(35 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Olbert et al showed better survival in men with PSA flare or PSA decline than men with PSA failure. Similarly, Sella et al and Nelius et al showed the same tendency although statistical significance was not reached, consistent with the OS data in the present study. Thus, the prognosis in men with PSA flare seems to be equivalent to that of PSA responders, and superior to that of men with PSA failure.…”

Section: Discussionsupporting

confidence: 90%

Co‐introduction of a steroid with docetaxel chemotherapy for metastatic castration‐resistant prostate cancer affects PSA flare

et al. 2016

View full text Add to dashboard Cite

ObjectiveTo investigate the potential relationship of steroid usage with prostate-specific antigen (PSA) flare as well as the prognostic impact of PSA flare, which is known to occur in 10-20% of patients with metastatic castration-resistant prostate cancer during docetaxel chemotherapy. Patients and MethodsThis study included 71 patients with metastatic castrationresistant prostate cancer treated by docetaxel chemotherapy with co-introduction of a steroid. PSA flare was defined as a transient PSA increase followed by a PSA decrease. ResultsPSA flare was recognized in 7.0-23.9% of patients according to the definition used. Intriguingly, men with steroid intake before the initiation of docetaxel chemotherapy experienced significantly fewer PSA flares. The progression-free survival rate in men with PSA flare was equivalent to that of PSA responders, but significantly better than men with PSA failure. ConclusionsOur results suggest that de novo steroid co-introduction with docetaxel chemotherapy induces the PSA flare phenomenon. This novel finding may account for the mechanism of PSA flare as well as being valuable for distinguishing PSA elevation attributable to PSA flare from that attributable to PSA failure.

show abstract

Section: Discussionsupporting

confidence: 90%

Co‐introduction of a steroid with docetaxel chemotherapy for metastatic castration‐resistant prostate cancer affects PSA flare

et al. 2016

View full text Add to dashboard Cite

show abstract

“…The PSA response and the relief of bone pain may aid the recognition of these pitfalls in the clinical images, and in consequence, support the continuation of the chemotherapy treatment. Similarly, cases of PSA flare phenomenon (28) and pain flare phenomenon (29) have been previously reported. Therefore, it has been proposed that the pain and PSA response are associated with survival, but are not adequate to use as surrogate end points, according to the TAX-327 study, which developed a prognostic model and nomogram using baseline clinical variables to predict mortality among males diagnosed with castration resistant prostate cancer (8,9).…”

Section: Discussionsupporting

confidence: 58%

False-positive diagnosis of disease progression by magnetic resonance imaging for response assessment in prostate cancer with bone metastases: A case report and review of the pitfalls of images in the literature

et al. 2015

Oncology Letters

View full text Add to dashboard Cite

Abstract. Bone metastases are common in prostate cancer. However, differentiating neoplastic from non-neoplastic alterations of bone on images is challenging. In the present report, a rare case of bone marrow reconversion on magnetic resonance imaging (MRI) assessment, which may lead to a false-positive diagnosis of disease progression of bone metastases in hormone-resistant prostate cancer, is presented. Furthermore, a review of the literature regarding the pitfalls of images for response assessment, including the 'flare' pheno menon on bone scintigraphy, computed tomography (CT), positron emission tomography/CT and marrow reconversion on MRI is also provided. These inaccuracies, which may lead to a premature termination of an efficacious treatment, should be carefully considered by the radiologists and oncologists involved in clinical trials. The case reported in the present study showed how to assess the early therapeutic response and select the appropriate treatment for the patient when these pitfalls are encountered on clinical images.

show abstract

“…However, it is important to be aware of the PSA flare-up phenomenon, which leads to a transient PSA elevation following chemotherapy (13). In the current study, two patients exhibited an increase in their PSA levels on initiation of treatment, which was followed by a decline in PSA levels after five weeks (Table IV).…”

Section: Discussionmentioning

confidence: 99%

Clinical predictor of survival following docetaxel-based chemotherapy

Lee

Huang

et al. 2014

Oncology Letters

View full text Add to dashboard Cite

Prostate cancer (PCa) is the most common type of cancer in males in the USA and the incidence is increasing. For castration-resistant PCa (CRPC), previous studies have identified docetaxel-based chemotherapy as the first-line therapy. In the present study, the efficacy of docetaxel-based chemotherapy was investigated in a population of patients with CRPC. This study included 26 individuals (mean age, 73 years) with CRPC who were patients between July 2007 and October 2012 at the Kaohsiung Medical University Hospital (Kaohsiung, Taiwan). The regimen consisted of intravenous docetaxel (70 mg/m2) once every four weeks plus oral prednisolone (5 mg) twice daily for five days. Prostate-specific antigen (PSA) response (defined as a PSA decrease of >50% over four weeks), time to PSA progression, PCa-specific survival and overall survival (OS) were evaluated. For these 26 patients, the mean PSA level prior to chemotherapy treatment was 335.58 ng/ml. During follow-up, the average number of cycles of chemotherapy was approximately seven and 15 patients (58%) achieved a PSA response. PSA response was found to significantly correlate with OS and PCa-specific survival (P=0.014 and P=0.028, respectively). The mean value of the PSA nadir level was 89.97 ng/ml and time to PSA nadir was five months. The most common adverse event was leucopenia, which affected 88% of the patients. The results indicated that the length of time to PSA nadir and the occurrence of leucopenia may impact the PSA response. The docetaxel-based chemotherapy was a feasible and effective treatment regimen in patients with CRPC. However, the occurrence of adverse events, particularly the high incidence of leucopenia, may be cause for concern.

show abstract

Impact of PSA flare-up in patients with hormone-refractory prostate cancer undergoing chemotherapy

Cited by 36 publications

References 32 publications

Co‐introduction of a steroid with docetaxel chemotherapy for metastatic castration‐resistant prostate cancer affects PSA flare

Co‐introduction of a steroid with docetaxel chemotherapy for metastatic castration‐resistant prostate cancer affects PSA flare

False-positive diagnosis of disease progression by magnetic resonance imaging for response assessment in prostate cancer with bone metastases: A case report and review of the pitfalls of images in the literature

Clinical predictor of survival following docetaxel-based chemotherapy

Contact Info

Product

Resources

About